A Commentary on Weighing the Options: Criteria for Evaluating Weight‐Management Programs

The United States is in the midst of an epidemic of obesity.Over one third of all adults and one fourth of children and adolescents are considered obese.Obesity is associated with increased morbidity and mortality.It is estimated that in the United States the yearly economic cost of obesity approaches $100 billion, and there are 300,000 excess deaths per year that can be attributed to this disease.The National Institutes of Health spend about 50 cents per obese patient each year on research in obesity.. . .Despite the economic and personal costs of obesity, it is one of the only chronic diseases whose treatment is specifically excluded from most health-insurance plans and managed-care programs.This mirrors the view held by the lay public and many health-care providers that obesity is due to "willful misconduct" -eating too much and exercising too little.As a result, obese individuals not only suffer economic discrimination on the job, but they are also discriminated against in receiving appropriate treatment for their disease.Those of us who are involved in obesity research and/or the treatment of obese individuals are well aware that obesity is a complex disease with a strong biological basis involving genetics, physiology, metabolism, and the neurosciences as well as environmental, psychosocial and cultural factors.No uniform national standards are used to evaluate "success" of treatment programs.With the publication of the report Weighing the Options (see page 599 of this issue) by the Food and STERN.